PEDIATRICS Vol. 119 No. 5 May 2007, pp. 1036-1037 (doi:10.1542/peds.2007-0180)
LETTER TO THE EDITOR |
Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development
Zsanett Csoma, MD, PhDDepartment of Dermatology and Allergology
Peter Hencz, MD, PhD
Department of Pediatrics
Hajnalka Orvos, MD, PhD
Department of Obstetrics and Gynecology
Lajos Kemeny, MD, DSc
Attila Dobozy, MD, DSc
Eva Dosa-Racz
Zsuzsanna Erdei, MD
Dora Bartusek, MD
Judit Olah, MD, PhD
Department of Dermatology and Allergology
University of Szeged
H-6720 Szeged, Hungary
To the Editor.—
The number of individuals with large numbers of common and atypical melanocytic nevi has been continuously increasing in several white populations. Subjects with dysplastic nevi are at a substantially increased risk for the development of both uveal and cutaneous malignant melanoma.1,2
Numerous epidemiologic data have demonstrated that sunlight exposure is the major environmental factor involved in the development of melanoma, and it also exerts a considerable influence on the nevus count of an individual.3 Blue-light phototherapy has been widely and successfully used for the treatment of neonatal jaundice to reduce the plasma concentration of bilirubin and, thus, to prevent kernicterus.4 So far, little is known about the long-term impact of neonatal phototherapy on nevus development.
In 2002 and 2003, 747 schoolchildren aged 14 to 18 years were investigated to determine the prevalence of common and atypical melanocytic nevi. Data were recorded with regard to the neonatal history of the students, such as prematurity, neonatal jaundice and blue-light phototherapy; 44.6% of the children had received phototherapy for the treatment of neonatal jaundice. Our results revealed that the prevalence of common melanocytic nevi was quite similar in the treated and untreated children, but exposed subjects were likely to have multiple (>100) moles. Neonatal blue-light phototherapy was associated with a significantly higher prevalence of clinically atypical nevi (
2 = 4.08; degrees of freedom = 1; P = .0433 [Statistica 7.1; StatSoft, Inc, Tulsa, OK]). The prevalence of dysplastic nevi was 19.1% in the untreated group and 25.2% in the treated group. Blue-light phototherapy resulted in a relative risk of 1.32 for the development of dysplastic nevus (odds ratio: 1.43; 95% confidence interval: 1.010–2.026). Bauer et al5 have reported that phototherapy of neonatal jaundice using a blue-light lamp is not associated with an increased risk of development of melanocytic nevi in children aged 2 to 7 years. Common melanocytic nevi first appear in early childhood, whereas dysplastic nevi arise in late childhood, usually around puberty. Accordingly, we focused on this age group in our study.
Because having a clinically atypical nevi is the most important independent phenotypic risk factor for the development of malignant melanoma, our data highlight the need for the dermatologic screening of children with a history of neonatal phototherapy. Phototherapy with blue-light lamps is a standard and essential therapeutic modality in neonatal care; therefore, additional studies are necessary to establish its potential long-term adverse effects.
ACKNOWLEDGMENTS
This study was supported by the National Fund of the Hungarian Ministry of Health (ETT 500/2006 grant).
REFERENCES
- Kraemer KH, Greene MH, Tarone R, Elder DE, Clark WH Jr, Guerry D 4th. Dysplastic naevi and cutaneous melanoma risk. Lancet. 1983;2 (8358):1076–1077
- Hammer H, Toth-Molnar E, Olah J, Dobozy A. Cutaneous dysplastic naevi: risk factor for uveal melanoma. Lancet. 1995;346 :255 –256[Web of Science][Medline]
- Kopf AW, Kripke ML, Stern RS. Sun and malignant melanoma. J Am Acad Dermatol. 1984;11 :674 –684[Web of Science][Medline]
- Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia.
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[Free Full Text] - Bauer J, Buttner P, Luther H, Wiecker TS, Mohrle M, Garbe C. Blue light phototherapy of neonatal jaundice does not increase the risk for melanocytic nevus development. Arch Dermatol. 2004;140 :493 –494[CrossRef][Web of Science][Medline]
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics
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